Lotilaner ophthalmic solution shows strong results in treating Demodex blepharitis

Lotilaner ophthalmic solution (0.25%) is a safe and effective FDA-approved treatment for Demodex blepharitis, significantly reducing collarettes, mite density, and erythema over 6 weeks with minimal adverse effects and high patient comfort, according to a study.

A pooled analysis of 2 randomized, double-masked, vehicle-controlled studies—Saturn-1 and Saturn-2—evaluated its safety and effectiveness over 6 weeks.

The trials included 833 patients assigned to a lotilaner or a vehicle control. By day 43, 49.8% of treated patients achieved near-complete collarette clearance, compared to 9.9% in the control group (P < 0.0001). In addition, 85.1% of the treatment group had significant collarette reduction (≤10), versus 28.0% in the control group. Mite eradication (60.2% vs 16.1%) and erythema resolution (24.9% vs 7.9%) were also significantly higher with lotilaner (P < 0.0001).

Adverse events were minimal, with no serious ocular reactions reported. Notably, 92% of patients rated the drops as neutral to very comfortable.

Reference
Yeu E, Paauw JD, Vollmer P, et al. Safety and Efficacy of Lotilaner Ophthalmic Solution (0.25%) in Treating Demodex Blepharitis: Pooled Analysis of Two Pivotal Trials. Ophthalmol Ther. 2025;doi: 10.1007/s40123-024-01089-5. Epub ahead of print. PMID: 39873946.